Publications by authors named "Qiaozhu Chen"

7 Publications

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Maternal dietary patterns during pregnancy and preterm delivery: a large prospective cohort study in China.

Nutr J 2018 07 25;17(1):71. Epub 2018 Jul 25.

Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, 510623, China.

Background: Evidence about the associations between maternal dietary patterns and preterm delivery is scarce in Eastern countries. The purpose of this study was to examine the associations between maternal dietary patterns during pregnancy and preterm delivery in a Chinese population.

Methods: A total of 7352 mothers were included in the Born in Guangzhou Cohort Study, a prospective study in China. A validated self-administered food frequency questionnaire (FFQ) was used to assess maternal diet at 24-27 weeks of gestation. Dietary patterns were identified by cluster analysis. Gestational age was obtained from routine medical records. Preterm delivery was defined as delivery before 37 completed weeks of gestation, and was further classified into spontaneous and iatrogenic preterm delivery, and also early/moderate and late preterm delivery. Associations between dietary patterns and preterm delivery outcomes were assessed using logistic regression analyses.

Results: Six dietary patterns were identified, including 'Milk', 'Cereals, eggs, and Cantonese soups', 'Meats', 'Fruits, nuts, and Cantonese desserts', 'Vegetables', and 'Varied'. There were 351 (4.8%) preterm deliveries in this study population. Among those of preterm delivery, 16.2 and 83.8% were early/moderate and late preterm delivery, respectively. Compared with women of 'Vegetables' pattern, those of 'Milk' pattern had greater odds of overall preterm delivery (adjusted odds ratio [OR] 1.59, 95% confidence interval [CI] 1.11, 2.29, p < 0.05), spontaneous preterm delivery (adjusted OR 1.73, 95% CI 1.14, 2.62, p < 0.05) and late preterm delivery (adjusted OR 1.73, 95% CI 1.08, 2.62, p < 0.05); those of 'Cereals, eggs, and Cantonese soups' and 'Fruits, nuts, and Cantonese desserts' patterns had greater odds of late preterm delivery (adjusted OR 1.54, 95% CI 1.01, 2.35 for 'Cereals, eggs, and Cantonese soups', adjusted OR 1.61, 95% CI 1.04, 2.50 for 'Fruits, nuts, and Cantonese desserts', respectively).

Conclusion: Maternal diet with frequent consumption of milk and less frequent consumption of vegetables during pregnancy might be associated with increased odds of preterm delivery. Future interventions should investigate whether increasing vegetable intake reduces preterm deliveries.
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http://dx.doi.org/10.1186/s12937-018-0377-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6060524PMC
July 2018

Prediction of gestational diabetes mellitus in the Born in Guangzhou Cohort Study, China.

Int J Gynaecol Obstet 2018 Nov 6;143(2):164-171. Epub 2018 Aug 6.

Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.

Objective: To assess potential risk factors in identifying women at risk for gestational diabetes mellitus (GDM).

Methods: The present study included data collected as part of a prospective cohort study, and included women with singleton pregnancies who underwent initial prenatal examination at a tertiary women and children's hospital in Guangzhou, China between February 1, 2012, and December 31, 2015. Maternal characteristics and medical history were investigated to evaluate associations with GDM. A risk factor scoring system for the prediction of GDM was generated using logistic regression.

Results: Overall, 1129 (13.5%) of 8381 women were diagnosed with GDM. Women older than 35 years had a 3.95-fold increased risk of GDM (95% confidence interval 2.80-5.58) compared with women aged 16-25 years; obese women had a 6.54-fold higher risk (95% confidence interval 3.50-12.23) compared with underweight women. A risk scoring system was established based on age, body mass index, family history of diabetes, weight gain, and history of GDM. Screening for women with a score of 12 or more would have reduced the number undergoing oral glucose tolerance testing by 2131 (25.4%) patients with a sensitivity of 87% for GDM detection.

Conclusion: The assessment of risk factors for GDM could provide a foundation for improving risk-based screening strategies in this and similar populations.
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http://dx.doi.org/10.1002/ijgo.12627DOI Listing
November 2018

Is the Collapsibility Index of the Inferior Vena Cava an Accurate Predictor for the Early Detection of Intravascular Volume Change?

Shock 2018 Jan;49(1):29-32

*Department of Emergency and Critical Care Medicine, Dongguan Kanghua Hospital, Dongguan, Guangdong, China†Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China‡Weil Institute of Emergency and Critical Care Medicine, School of Medicine, Virginia Commonwealth University, Richmond, Virginia§Department of the Neurology Intensive Care Unit, the First Hospital Affiliated to Jinan University, Guangzhou, Guangdong, China||Department of Ultrasound, Dongguan Hospital Affiliated to Medical College of Jinan University, Dongguan, Guangdong, China¶Department of Emergency Medicine, Virginia Commonwealth University, Richmond, Virginia.

The ultrasonographic evaluation of inferior vena cava (IVC) parameters, particularly the collapsibility index (CI), has been widely used in the assessment of the fluid responsiveness of critically ill patients, but the results are conflicting. In this study, we aimed to investigate the early change in CI after increased intravascular volume (IVV) induced by passive leg raising (PLR). A total of 145 healthy volunteers over 18 years old were enrolled between September and December in 2015. Before and 2 min after PLR, the maximum and minimum IVC diameters (maxIVC and minIVC) were measured by color Doppler ultrasonography, and the difference in CI (ΔCI) was calculated. The heart rate (HR) and noninvasive mean arterial pressure (MAP) were also monitored. We found that there was a significant increase in the mean maxIVC and minIVC values and a reduction in CI. Nevertheless, no significant differences in HR or MAP were observed before or 2 min after PLR. The baseline CI had no relationship with individual characteristics and a multiple linear regression analysis of the ΔCI and individual characteristics showed that age, baseline CI, and BMI were independent variables for ΔCI. In conclusion, IVC-CI measured by ultrasound is useful for the detection of early IVV change induced by 2 min PLR. However, its ability to detect the increased IVV value is influenced by age, BMI, and baseline CI. Moreover, only 50.3% of the subjects had an IVC-CI reduction of more than 10%, making IVC-CI of little value for clinical applications, due to its poor sensitivity.
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http://dx.doi.org/10.1097/SHK.0000000000000932DOI Listing
January 2018

Congenital Heart Disease in Local and Migrant Elementary Schoolchildren in Dongguan, China.

Am J Cardiol 2016 Feb 18;117(3):461-4. Epub 2015 Nov 18.

Department of Cardiology, the Dongguan Affiliated Hospital of Medical College of Jinan University, the Fifth People's Hospital of Dongguan (also called Taiping People's Hospital of Dongguan), Guangdong, China.

The aim of this study was to determine the prevalence and treated status of congenital heart disease (CHD) in elementary schoolchildren and facilitate the long-term planning of health care, resource allocation, and development of targeted primary prevention strategies. From November 2011 to November 2012, 540,574 schoolchildren from 449 elementary schools were screened for CHD by trained doctors in Dongguan City. The schoolchildren who were suspected to have CHD were referred to a pediatric cardiologist and/or an echocardiographist for complete evaluation. Of them, 214,634 (39.7%) were local children and 325,940 (60.3%) were migrant children. The total prevalence of CHD was 2.14‰, and there was a significant difference (p <0.05) of the CHD prevalence between local (1.97‰) and migrant children (2.26‰). The treatment rates of CHD in local children and in migrant children were 63.51% and 47.21%, respectively (p <0.01). The commonest CHD was ventricular septal defect (43.13%), followed by atrial septal defect (25.84%) and patent ductus arteriosus (12.79%). With respect to gender, CHD was equally distributed between men and women. In conclusion, social, economic, and environmental risk factors that affect health of migrant children with CHD call for more attention from health policy makers and researchers in contemporary China. Efforts should be made to increase public health investment, establish health care manage system for children from migrant families, and increase the parents' awareness of preventing the CHD.
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http://dx.doi.org/10.1016/j.amjcard.2015.10.061DOI Listing
February 2016

Impact of individual characteristics on sonographic IVC diameter and the IVC diameter/aorta diameter index.

Am J Emerg Med 2015 Nov 23;33(11):1602-5. Epub 2015 Jun 23.

Department of the General Intensive Care Unit, Dongguan Hospital Affiliated to Medical College of Jinan University, Dongguan 523905, Guangdong, China.

Background: The inferior vena cava (IVC) parameters, including its diameter and collapsibility index have been evaluated for fluid status for over 30 years, but little is known about the impacts of patient characteristics on IVC parameters. The purpose of this study was to explore the relationships between individual patient characteristics and IVC parameters in healthy Chinese adult volunteers.

Methods: From February 2012 to May 2012, 216 healthy volunteers older than the age of 18 years were consecutively enrolled in our study. The individual characteristics and presence or absence of hypertension of each participant were recorded. Sonographic measurements of IVC and abdominal aorta diameter (Ao) were performed (DP-6900; Mindray, Shenzhen, China).

Results: Volunteers ranged in age from 18 to 84 years (43.7 ± 7.8 years), and 50.5% were males. In univariate analyses, maximum IVC diameter (IVCmax) was negatively correlated with age (years) (r = -0.171, P = .012) and positively correlated with sex (men) (r = 0.174, P = .01), height (centimeters) (r = 0.281, P < .001), and body surface area (square meters) (r = 0.173, P = .011). The IVC/Ao index was negatively correlated with age (years) (r = -0.326, P < .001), waist circumference (centimeters) (r = -0.176, P = .01), body mass index (r = -0.173, P = .011), and hypertension (r = -0.186, P = .006). None of the patient characteristics were significantly correlated with percentage collapse of the IVC. Height (centimeters) was the sole significant predictor of IVCmax (R(2) = 0.079, P < .001). Age (years) and body mass index (kilogram/square meter) were independent predictors of the IVC/Ao index (R(2) = 0.123; P < .001 and P = .046, respectively).

Conclusions: The percentage collapse of IVC and the IVCmax are not substantially influenced by patient characteristics. In contrast, the IVC/Ao index is more susceptible to patient characteristics than IVC.
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http://dx.doi.org/10.1016/j.ajem.2015.06.047DOI Listing
November 2015

Prevalence and clinical significance of cardiac murmurs in schoolchildren.

Arch Dis Child 2015 Nov 12;100(11):1028-31. Epub 2015 Jun 12.

Department of Cardiology, The Dongguan Affiliated Hospital of Medical College of Jinan University, the Fifth People's Hospital of Dongguan (also called Taiping People's Hospital of Dongguan), Dongguan, Guangdong, China.

Objective: To determine the prevalence and clinical significance of heart murmurs detected during heart disease screening among apparently healthy schoolchildren.

Design: Cross-sectional study.

Setting: 32 elementary schools in Dongguan City of China.

Patients: 81,213 schoolchildren aged 5-13 years from different elementary schools.

Main Outcome Measures: The prevalence and clinical significance of heart murmurs among schoolchildren.

Results: Murmurs were detected in 2193 schoolchildren (2.7%), of whom 215 had a structural heart disease (SHD). Of patients who had SHD, 198 children had congenital heart disease (CHD), 12 had mitral valve prolapse and 5 had rheumatic heart disease. In patients who had CHD, the most common diagnosis was a ventricular septal defect. With respect to sex, SHDs were equally distributed between males and females. Of the schoolchildren who had a murmur, 1797 (81.9%) had a murmur with the loudness of grade 1 or 2 and 396 (18.1%) had a murmur with the loudness of grades 3-6. The prevalence of SHD fell significantly with increasing age.

Conclusions: The study suggested that apparently healthy schoolchildren with grade ≤2 cardiac murmurs are least likely to have underlying SHD, especially in those aged ≥10 years. However, echocardiography should be performed in younger schoolchildren with cardiac murmur grade ≥3.
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http://dx.doi.org/10.1136/archdischild-2014-307819DOI Listing
November 2015

The metabolic syndrome among postmenopausal women in rural Canton: prevalence, associated factors, and the optimal obesity and atherogenic indices.

PLoS One 2013 9;8(9):e74121. Epub 2013 Sep 9.

School of Biotechnology, Southern Medical University, Guangzhou, Guangdong Province, People's Republic of China ; Department of Primary Public Health, Canton Center for Disease Control and Prevention, Canton, Guangdong Province, People's Republic of China.

Objectives: This research aimed to (i) determine the prevalence of metabolic syndrome (MetS) and its components; (ii) assess factors associated with MetS, and (iii) define optimal ethnic-specific cutoffs of obesity- and atherogenic-based markers to predict MetS among postmenopausal women in rural Canton.

Methodology/principal Findings: The Rural Canton Diabetes and Metabolic Disorders Study, a population based cross-sectional study, was conducted during 2011-2012 in Canton. In person interviews, blood glucose and lipid measurements were completed for 4,706 postmenopausal women who did not receive hormone replacement therapy. MetS was diagnosed using criteria of the Joint-Interim-Statement (JIS), the International-Diabetes-Federation (IDF) and the Modified-Third-Adult-Treatment-Panel (M-ATPIII). Age-standardized prevalence of MetS was 38.4%, 28.8%, and 37.1% according to JIS, IDF, and M-ATPIII criteria, respectively. Excellent agreement was observed between three definitions (κ ≥ 0.79), in particular between JIS and ATPIII (κ = 0.98, 95%CI: 0.97-0.98). Factors positively associated with MetS were living in Southern Canton, personal income, current smoking, higher BMI, and family history of cardiovascular disease. However, regular leisure-time physical activity can have protective effects. The optimal cutoff values for waist-circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio(WHtR), BMI, HDL-cholesterol to total cholesterol ratio (HDL/TC), HDL-cholesterol to LDL-cholesterol ratio (HDL/LDL), and triglyceride to HDL-cholesterol ratio (TG/HDL) that predicted the presence of MetS were 79.5 cm, 0.86, 0.53, 22.47 kg/m(2), 0.33, 0.68, and 0.88, respectively.

Conclusions: This study highlights the importance of MetS among postmenopausal women in rural Canton. Our findings contribute to help selecting Cantonese-specific markers to predict MetS and support the need to establish educational program for promoting healthy-lifestyles among this population.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0074121PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3767690PMC
June 2014